Children's Long-Term Support Service (CLTS) Waiver Provider Registry

Are you interested in using your services to help children with disabilities?

More than 7,100 children with disabilities are currently being served through state waiver programs. That is projected to grow by 30 percent by the end of 2018. Many families are looking for local businesses and individuals to provide services that help their children increase or maintain their daily capabilities at home, school, or in the community.

The Children's Long-Term Support (CLTS) Waiver Program supports the needs of children with disabilities with a wide array of services both in the home and out in the community.

Registering with the Department of Health Services (DHS) is the first step in becoming an approved provider of CLTS waiver services. After you submit your registration, DHS forwards your information to the county waiver agency (CWA) in the area you wish to provide services. The CWA will manage the rest of the qualification process.

For more information about service descriptions and qualifications, see the CLTS Benefit Package (PDF).

How to Register

All new and current providers must complete the steps below to register. DHS requires providers to re-register every four years.

Note: If you are a direct care employee of a provider or submit time sheets to a fiscal agent, do not complete this registration process.

  1. Before you register, gather the following:
    • Completed Medicaid Waiver Provider Agreement (see the Program Resources tab to choose the appropriate form)
    • Business information (business name as reported to the IRS, tax ID number, national provider identifier)
  2. Fill out the online Children's Long-Term Support Waiver Provider Registry, F-02341A.
  3. After you submit your registration, DHS forwards your information to the county waiver agency (CWA) in the area you wish to provide services. The CWA will manage the rest of the qualification process (see the Who to Contact tab).

New! DHS is launching a searchable online CLTS Waiver Provider Directory that will be available to the general public.

Note: All providers must complete the entire registration process. Filling out the CLTS Waiver Provider Registry does not mean you are approved as a qualified provider authorized to deliver services.

Questions? Please email the DHS Provider Registry.

Who to Contact

After you've completed the CLTS Provider Registry, contact the CWA(s) where you are interesting in delivering services. They will manage the rest of the provider approval process, including conducting screening activities, verifying your credentials, and issuing any authorizations.

Questions? Please email the DHS Provider Registry.

Program Resources

Medicaid Waiver Provider Agreement forms

When you register, you will need to upload a completed Medicaid Waiver Provider Agreement form to the Provider Registry. Choose the appropriate form from the list below.

Payment Information

DHS contracts with Wisconsin Physicians Service (WPS) as the third-party administrator (TPA). WPS processes and issues payments to providers, reports claims data to DHS, and recovers overpayments per federal regulations. Once you have been approved as a provider and start delivering services, you will submit claims to WPS for payment.

DHS is currently developing statewide payment rates for most CLTS waiver services. Providers will be paid based on these rates starting in January 2019. You can find out more at the CLTS Waiver Service Rates Initiative page.

Last Revised: August 3, 2018